| 引用本文: |
曹玲, 吴鹏飞, 邹岳萍, 曹瑛.参地养心胶囊联合西医常规疗法对慢性心力衰竭患者的临床疗效及对NT-proBNP、sST2的影响[J].湖南中医药大学学报,2025,45(2):382-388[点击复制] |
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| 参地养心胶囊联合西医常规疗法对慢性心力衰竭患者的临床疗效及对NT-proBNP、sST2的影响 |
| 曹玲,吴鹏飞,邹岳萍,曹瑛 |
| (湖南中医药大学附属衡阳医院, 湖南 衡阳 421001) |
| 摘要: |
| 目的 观察参地养心胶囊联合西医常规疗法对慢性心力衰竭（CHF）气阴两虚证患者的临床疗效。方法 选取2022年10月至2023年12月就诊于湖南中医药大学附属衡阳医院心内科的CHF气阴两虚证患者90例，按随机数字表法分为观察组（n=45）和对照组（n=45）。对照组给予常规西药治疗；观察组在对照组基础上加用参地养心胶囊治疗，一次4粒，3次/d。疗程均为1个月。比较治疗前后两组的中医证候积分、心功能疗效、心功能相关指标[包括N末端脑钠肽前体（NT-proBNP）、可溶性生长刺激表达基因2蛋白（sST2）、左室射血分数（LVEF）、左心室收缩末期内径（LVESD）和左心室舒张末期内径（LVEDD）]、6分钟步行试验（6MWT）及明尼苏达心力衰竭生存质量表（MLHFQ），对比两组治疗过程中的安全性指标。结果 治疗前，两组患者中医证候积分、心功能相关指标、运动耐量、生活质量评价、安全性观测结果比较，差异均无统计学意义（P＞0.05）。治疗1个月后，观察组的心功能疗效（95.56%）高于对照组（86.67%）（P<0.05），两组中医证候积分、NT-proBNP、sST2、LVESD、LVEDD、MLHFQ水平均较治疗前降低（P<0.05，P<0.01），LVEF、6MWT水平均较治疗前升高（P<0.01）。与对照组比较，治疗后观察组中医证候积分、NT-proBNP、sST2、LVESD、LVEDD、MLHFQ均降低（P<0.05，P<0.01），LVEF、6MWT水平均升高（P<0.01）。两组患者在用药期间均未出现肝肾功能异常。结论 在西医常规治疗基础上口服参地养心胶囊治疗CHF气阴两虚证患者，能改善患者心功能及中医证候，减少心肌纤维化，提高患者运动耐量和生活质量，具有较好的临床疗效。 |
| 关键词: 慢性心力衰竭 参地养心胶囊 气阴两虚证 N末端脑钠肽前体 可溶性生长刺激表达基因2蛋白 |
| DOI：10.3969/j.issn.1674-070X.2025.02.029 |
| 投稿时间：2024-07-13 |
| 基金项目:湖南省中医药管理局课题（2019120）；黄云名老中医传承工作室[国中医药人教函〔2022〕75号]；衡阳市科技局指导性项目（201950）。 |
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| Clinical efficacy of Shendi Yangxin Capsule combined with conventional Western medicine therapy in patients with chronic heart failure and its effects on NT-proBNP and sST2 |
| CAO Ling, WU Pengfei, ZOU Yueping, CAO Ying |
| (Hengyang Hospital affiliated to Hunan University of Chinese Medicine, Hengyang, Hunan 421001, China) |
| Abstract: |
| Objective To investigate the clinical efficacy of Shendi Yangxin Capsule (SDYXC) combined with conventional Western medicine therapy on patients with chronic heart failure (CHF) of qi and yin deficiency pattern. Methods A total of 90 patients with CHF of qi and yin deficiency pattern admitted to the Department of Cardiology, Hengyang Hospital Affiliated to Hunan University of Chinese Medicine from October 2022 to December 2023 were selected and divided into observation group (n=45) and control group (n=45) by the random number table method. The control group was treated with conventional Western medicine, while the observation group was treated with SDYXC in addition to the conventional Western medicine, at a dosage of four capsules per time, three times a day. The treatment course for both groups was one month. The Chinese medicine (CM) pattern scores, cardiac function efficacy, cardiac function-related indicators [including N-terminal pro-B-type natriuretic peptide (NT-proBNP), soluble suppression of tumorigenicity-2 (sST2), left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD)], measurements of six-minute walk test (6MWT), and scores of Minnesota Living with Heart Failure Questionnaire (MLHFQ) were compared between the two groups before and after treatment, and the safety indicators during treatment were also compared between the two groups. Results There were no significant differences in CM pattern scores, cardiac function-related indicators, exercise tolerance, quality of life evaluation, and safety observation results between the two groups before treatment (P>0.05). After a month of treatment, the cardiac function efficacy in the observation group (95.56%) was higher than that in the control group (86.67%) (P<0.05). The CM pattern scores, levels of NT-proBNP and sST2, LVESD, LVEDD, and MLHFQ scores in both groups were lower than those before treatment (P<0.05, P<0.01), while the levels of LVEF and 6MWT were higher than those before treatment (P<0.01). Compared with the control group, the CM pattern scores, levels of NT-proBNP and sST2, LVESD, and LVEDD decreased in the observation group after treatment (P<0.05, P<0.01), while LVEF and 6MWT levels increased (P<0.01). No abnormal liver and kidney function occurred in both groups during the treatment period. Conclusion Oral administration of SDYXC, in addition to conventional Western medicine treatment, for patients with CHF of qi and yin deficiency pattern can improve cardiac function and CM pattern, reduce myocardial fibrosis, and enhance exercise tolerance and life quality, demonstrating good clinical efficacy. |
| Key words: chronic heart failure Shendi Yangxin Capsule qi and yin deficiency pattern N-terminal pro-B-type natriuretic peptide soluble suppression of tumorigenicity-2 |
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